What is Lactose Free Diet

If you have lactose intolerance, you are not able to digest lactose. Lactose is a natural sugar found mainly in dairy milk and dairy products. You may need to avoid all foods and beverages that contain lactose. A lactose-free diet can help you do this.

Which foods have lactose?

Lactose is found in dairy milk and dairy products, such as:

• Yogurt.
• Cheese.
• Butter.
• Margarine.
• Sour cream.
• Cream.
• Whipped toppings and nondairy creamers.
• Ice cream and other dairy-based desserts.

Lactose is also found in foods or products made with dairy milk or milk ingredients. To find out whether a food contains dairy milk or a milk ingredient, look at the ingredients list. Avoid foods with the statement “May contain milk” and foods that contain:

• Milk powder.
• Whey.
• Curd.
• Caseinate.
• Lactose.
• Lactalbumin.
• Lactoglobulin.

What are alternatives to dairy milk and foods made with milk products?

• Lactose-free milk.
• Soy milk with added calcium and vitamin D.
• Almond milk, coconut milk, rice milk, or other nondairy milk alternatives with added calcium and vitamin D. Note that these are low in protein.
• Soy products, such as soy yogurt, soy cheese, soy ice cream, and soy-based sour cream.
• Other nut milk products, such as almond yogurt, almond cheese, cashew yogurt, cashew cheese, cashew ice cream, coconut yogurt, and coconut ice cream.

What are tips for following this plan?

• Do not consume foods, beverages, vitamins, minerals, or medicines containing lactose. Read ingredient lists carefully.

Reading food labels

• Check food ingredient lists carefully. Avoid foods made with butter, cream, milk, milk solids, milk powder, curd, caseinate, or whey.
• Avoid products with the note “may contain milk.”
• Look for the words “lactose-free” or “lactose-reduced” on food labels. You can eat lactose-free foods, and you may be able to eat small amounts of lactose-reduced foods.

• Look for the words “lactose-free” on labels.
• Use lactase enzyme drops or tablets as directed by your health care provider.
• Use lactose-free milk or a milk alternative, such as soy milk or almond milk, for drinking and cooking.
• Make sure you get enough calcium and vitamin D in your diet. A lactose-free eating plan can be lacking in these important nutrients.
• Take calcium and vitamin D supplements as directed by your health care provider. Talk to your health care provider about supplements if you are not able to get enough calcium and vitamin D from food.

Shopping

• Look for nondairy substitutes, such as:
  • Nondairy creamer.
  • Almond or soy milk.
  • Soy or coconut yogurt.
  • Dairy-free cheese.
• Buy lactose-free cow milk.

Cooking

• Avoid cooking with butter. Use vegetable, nut, and seed oils instead.
• Prepare soups without cream. Use other products to thicken soups, such as corn starch or tomato paste.

Meal planning

• Avoid eating foods that contain lactose.
• Some people with lactose intolerance can eat foods that contain small amounts of lactose. Foods that contain less than 1 gram of lactose per serving include:
  • 1–2 oz of aged cheese, such as Parmesan, Swiss, or cheddar.
  • 2 Tbsp of cream cheese.
  • ⅓ cup of cottage cheese.
  • ½ cup of ricotta cheese.
• Some people are able to tolerate cultured dairy products, such as yogurt, buttermilk, and kefir. The healthy bacteria in these products helps you digest lactose.
• If you decide to try a food that contains lactose:
  • Eat only one food with lactose in it at a time.
  • Eat only a small amount of the food.
  • Stop eating the food if your symptoms return.

What foods can I eat?

Fruits

All fresh, canned, frozen, or dried fruits that are not processed with lactose.

Vegetables

All fresh, frozen, and canned vegetables without cheese, cream, or butter sauces.

Grains

Any that are not made with dairy milk or dairy products.

Meats and other proteins

Any meat, fish, poultry, and other protein sources that are not made with dairy milk or dairy products. Soy cheese and yogurt.

Fats and oils

Any that are not made with dairy milk or dairy products.

Beverages

Lactose-free milk. Soy, rice, or almond milk with added calcium and vitamin D. Fruit and vegetable juices.

Sweets and desserts

Any that are not made with dairy milk or dairy products.

Seasonings and condiments

Any that are not made with dairy milk or dairy products.

Calcium

Calcium is found in many foods that contain lactose and is important for bone health. The amount of calcium you need depends on your age:

• Adults younger than 50 years: 1,000 mg of calcium a day.
• Adults older than 50 years: 1,200 mg of calcium a day.

The amount of calcium your child needs depends on his or her age:

• Children 1–3 years old: 700 mg of calcium a day.
• Children 4–8 years old: 1,000 mg of calcium a day.
• Children 9–18 years old: 1,300 mg of calcium a day.

If you are not getting enough calcium, you may get it from other sources, including:

• Orange juice with calcium added. There are 300–350 mg of calcium in 1 cup of orange juice.
• Calcium-fortified soy milk. There are 300–400 mg of calcium in 1 cup of calcium-fortified soy milk.
• Calcium-fortified rice or almond milk. There are 300 mg of calcium in 1 cup of calcium-fortified rice or almond milk.
• Calcium-fortified breakfast cereals. There are 100–1,000 mg of calcium in calcium-fortified breakfast cereals.
• Spinach, cooked. There are 145 mg of calcium in ½ cup of cooked spinach.
• Edamame, cooked. There are 130 mg of calcium in ½ cup of cooked edamame.
• Collard greens, cooked. There are 125 mg of calcium in ½ cup of cooked collard greens.
• Kale, frozen or cooked. There are 90 mg of calcium in ½ cup of cooked or frozen kale.
• Almonds. There are 95 mg of calcium in ¼ cup of almonds.
• Broccoli, cooked. There are 60 mg of calcium in 1 cup of cooked broccoli.

Getting enough calcium

• Milk and milk products contain a lot of calcium, which is an important nutrient for your health. When you avoid milk and milk products, make sure to get calcium from other foods.
• Talk with your health care provider about how much calcium you need each day. The amount of calcium you need each day depends on your age and overall health.
• Nondairy foods that are high in calcium include:
  • Sardines and canned salmon.
  • Dried beans.
  • Almonds.
  • Turnip greens, collards, kale, and broccoli.
  • Calcium-fortified soy milk and tofu.
  • Calcium-fortified orange juice.
• Talk with your health care provider about vitamin and mineral supplements. Take supplements only as directed.

What foods are not recommended?

Fruits

None, unless they are made with dairy milk or dairy products.

Vegetables

None, unless they are made with dairy milk or dairy products.

Grains

Any grains that are made with dairy milk or dairy products.

Meats and other proteins

None, unless they are made with dairy milk or dairy products.

Dairy

All dairy products, including milk, goat’s milk, buttermilk, kefir, acidophilus milk, flavored milk, evaporated milk, condensed milk, dulce de leche, eggnog, yogurt, cheese, and cheese spreads.

Fats and oils

Any that are made with milk or milk products.

Margarines and salad dressings that contain milk or cheese. Cream. Half and half. Cream cheese. Sour cream. Chip dips made with sour cream or yogurt.

Beverages

Hot chocolate. Cocoa with lactose. Instant iced teas. Powdered fruit drinks. Smoothies made with dairy milk or yogurt.

Sweets and desserts

Any that are made with milk or milk products.

Seasonings and condiments

Chewing gum that has lactose. Spice blends if they contain lactose. Artificial sweeteners that contain lactose. Nondairy creamers.

Summary

• If you are lactose intolerant, it means that you have a hard time digesting lactose, a natural sugar found in milk and milk products.
• Following a lactose-free diet can help you manage this condition. Avoiding foods and drinks that contain lactose may help ease digestive problems such as diarrhea or stomach pain.
• When you avoid milk and milk products, make sure to get calcium from other foods.
• Calcium is important for bone health and is found in many foods that contain lactose. Talk with your health care provider about other sources of calcium.
• Take vitamin and mineral supplements only as directed by your health care provider.

The items listed above may not be a complete list of foods and beverages to avoid. Contact a dietitian for more information.